IntroductionType 2 diabetes mellitus, characterized by insulin resistance, corresponds to approximately 90% of cases of diabetes worldwide. Hyperglycemia in diabetes contributes to hyperfibrinogenemia and activates the coagulation cascade thereby producing atherothrombotic events.ObjectivesThis study was designed to evaluate the coagulation profile (activated partial thromboplastin time, prothrombin time and fibrinogen) in Type 2 diabetes and to analyze correlations between body mass index, fasting blood glucose, glycated hemoglobin and duration of diabetes with coagulation parameters.MethodsThis study included 60 type 2 diabetics and 30 controls. Diabetic patients were grouped in two sets based on the presence or absence of microvascular complications. The demographic profile and clinical details were recorded. Fasting blood glucose, glycated hemoglobin, coagulation parameters such as prothrombin time, activated partial thromboplastin time and fibrinogen along with other biochemical parameters were investigated.ResultsThere were statistically significant differences in the coagulation parameters between the two groups of diabetics (with and without complications). The present study also found significant correlations between age and the duration of diabetes with and without complications and coagulation parameters such as the activated partial thromboplastin time, which was found to be significantly lower, and fibrinogen, which was found to be significantly higher in subjects with complications compared to subjects without complications.ConclusionClinical tests for prothrombin time, activated partial thromboplastin time and fibrinogen are relatively inexpensive and readily available. The present study shows that shortened prothrombin time, activated partial thromboplastin time and increased fibrinogen levels might be useful hemostatic markers in diabetic patients, especially in those at high-risk for thrombotic complications.

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<p class="abstract"><strong>Background:</strong> The two most frequent types of microcytic hypochromic anemia in developing countries are beta thalassemia trait (𝛽-TT) and iron deficiency anemia (IDA). Several indices using blood cell count parameters have been suggested to differentiate between two. In this study we evaluated the reliability of three indices.</p><p class="abstract"><strong>Methods:</strong> The present cross-sectional study was carried out in 300 pregnant females in third trimester. Out of these, 90 microcytic hypochromic females were selected. Mentzers index, red cell distribution width index and Matos and Carvalho index (MCI) were calculated from the regular 3-part analyser haematological parameters.  </p><p class="abstract"><strong>Results:</strong> The Mentzer index was the most reliable index, as it had the highest sensitivity (97.62%), specificity (66.67%), and Youden’s index (64%) for detecting Iron deficiency anaemia; the Matos and Carvalho Index showed higher sensitivity (98.81%)but a much lower specificity (33.3%) and Youden’s index (32%) while the red cell distribution width index showed the sensitivity and specificity of 92.86% and 66.67%, respectively with Youden’s index of 59%.</p><p class="abstract"><strong>Conclusions:</strong> The Mentzer index provided the highest reliabilities for differentiating<strong> </strong>IDA from 𝛽-TT. The new indices have high sensitivities and positive predictive value for identifying IDA, making them useful for screening population at risk. </p>

Primary malignant spindle cell tumors are rare constituting 1.0% of breast malignancies. Spindle cell lesions occurring in soft tissues can occur in breast with overlapping morphologies. It can present as benign lesion and have inconclusive cytological findings, so easily missed if not properly dealt with. Stromal sarcoma should be diagnosed only after thorough sectioning and negative staining for p63, broad spectrum, and high molecular weight keratin. We present a case of right breast lump. Cytological features revealed fibro histiocytic lesion. There were no areas of necrosis, hemorrhage, or calcification. Histopathologically, it showed partially encapsulated tumor with cells arranged in sheets, composed of oval to epithelioid cells with spindling at places with moderate pleomorphism (mitotic activity 6-7/10 hpf). Differential diagnosis of primary stromal sarcoma, metaplastic sarcoma, and phyllodes was made. Immunohistochemistry revealed vimentin positivity with focal positivity of S-100. Desmin, cytokeratin and smooth muscle actin, p63, ER, PR, and Her2-neu were negative. A final diagnosis of primary breast sarcoma of neural origin was established with the help of histopathology and immunohistochemistry. To conclude, it is of utmost importance to identify primary stromal sarcomas as they are known to spread very rapidly and have a poor prognosis.

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